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Still tired with cpap

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e92type +0 points · 3 months ago Original Poster

I’ve been on a cpap machine for about 4 years now and for that long I don’t think it’s working. I’m 34 years old male. I was diagnosed with obstructed sleep apnea along with other conditions like overweight, prediabetes and hypertension. I was able to reverse all of it through ketogenic diet and lost about 35lbs. I am now at my goal weight. I’ve been through it all pulmonary, cardiologist, ENT and all of my tests are normal. The only thing I have is anxiety I get PVC frequently. Anyways I’ve had many type of machines and masks now I have the Phillips dream station and the philips dream wear. I’m also able to change my own pressure I know the little trick to do it. Even so with my prescribe pressure it’s not cutting it. I used a humidifier and the tube as well with or without it still same results. I tried messing with flex nothing helps. I miss waking up refresh and it’s a hit or miss hit thing. But I feel more tired than refresh more than anything. My ahi levels are good and no leaks either.

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bonjour +0 points · 3 months ago Sleep Commentator

Dreamstation is a model series, which 1 do you have?

I would suggest posting the daily detailed view from Sleepyhead. The data will help you to get much better advice. How are your Flow Limits and RERAs? One other thing prediabetes is to diabetes what Stage 1 is to cancer. You HAVE diabetes, just at an early stage.

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e92type +0 points · 3 months ago Original Poster
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Sierra +0 points · 3 months ago Sleep Innovater

As bonjour suggests a good starting point is to download SleepyHead and post a screenshot of your Daily Detail. It will look something like this. It is freeware and you need a PC or Mac and a SD card reader to transfer the data from your machine to the software.

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Biguglygremlin +0 points · 3 months ago Sleep Commentator

Hi e92type

It sounds like you have done very well.

Congratulations on accomplishing what so many of us wish to, but rarely ever manage.

I would love to know what steps you took to achieve it.

Without numbers I am only hypothesising but if you have largely removed the cause of Apnea why would a CPAP machine help you to feel refreshed?

What happens if you sleep (on your side) without the machine?

There could be many other causes for tiredness.

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e92type +0 points · 3 months ago Original Poster

Thank you very much it’s quite simple really and it’s easier said than done. Research ketogenic diet. It has help a lot of people reverse prediabetes and even stage 2. It’s pretty much a high fat, mid protein and little to no carbs. It’s tough but there are thousands of success stories and I’m one of them.

I know there are many factors and contributions on why I feel so tired. I feel generally worse without the machine even sleeping on my side. I usually get headaches or my throat really hurts.

With the machine I feel a bit better no headaches but I just don’t feel the energy I’m still slow throughout the day. Like I haven’t slept at all.

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Ruby +0 points · 3 months ago Sleep Commentator

I would think you also need to check that your anxiety and PVC's aren't causing fatigue. If all is good with the machine (try Sleepyhead) then other things need to be ruled out. Sounds like you have checked on a lot of them but sometimes a low normal reading can cause problems.

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MarkHanson +0 points · 3 months ago

I trust that you have shared all of this with both your Sleep Doctor and your durable equipment provider. If not, please do so.

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txmnjim +0 points · 3 months ago

I sure wish I knew how to change the pressure rate on my Phillips box...I'm having to set up another apt as they haven't seen me in a year and refusing to do so over the phone! Bad thing is my insurance rarely pays all the bill and usually sticks me with about $200 charge :(

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Sierra +0 points · 3 months ago Sleep Innovater

In your first post you said:

"I’m also able to change my own pressure I know the little trick to do it. Even so with my prescribe pressure it’s not cutting it. I used a humidifier and the tube as well with or without it still same results. I tried messing with flex nothing helps. I miss waking up refresh and it’s a hit or miss hit thing. But I feel more tired than refresh more than anything. My ahi levels are good and no leaks either."

If your AHI is good and your leaks are good, what would you accomplish by changing the pressure? As was mentioned before if you post your SleepyHead results we may be able to help you better understand what the machine is doing or not doing.

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txmnjim +0 points · 3 months ago

i was wanting to change my pressure since i've changed from a full mask, where i felt i was gasping for air so i needed it very high, to only nose pillows where i will need it much lower. thankfully, the docs are working in tomorrow! jim

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Sierra +0 points · 3 months ago Sleep Innovater

There may be a slight difference in pressure requirements for a nasal mask vs a full face mask, but it is unlikely to be significant, and I couldn't even guess which one might be higher. It may depend on the machine and the mask model. These machines do not measure the pressure right at the mask. They measure the pressure at the machine, and use algorithms to estimate the pressure at the mask, considering the hose type used, and intentional vent air required by the mask. If there are differences in pressures need due to the mask it is most likely due to errors in the estimation of the mask pressure.

The real pressure requirement is determined by the degree and type of apnea you are suffering from, and should be quite independent of the mask type. The most common mistake in setting the machine up is to have the pressure too low at the start of the ramp up. The DreamStation has a SmartRamp feature which will hold the pressure at a comfortable level until you go to sleep. I would ask your supplier to set it up for you with a ramp start pressure of about 7-8 cm. They should know how to do that.

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bonjour +0 points · 3 months ago Sleep Commentator

There is nothing different about different pressures needed between masks. By experience I've seen no difference to 1 or 2 cm more pressure needed fora a full face over pillow masks. YMMV as usual for all things.

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KangarooTailStew +0 points · 26 days ago

I had to turn the pressure down for nasal pillows too.

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Sierra +0 points · 26 days ago Sleep Innovater

The thing to keep in mind is that the important pressure is the mask pressure. What most people look at is set pressure which is measured inside the machine. Then the machine estimates mask pressure using what you have told it for mask type and hose type. There is always pressure drop in the hose and mask and the machine has to compensate for that. I think the problem is that the compensation is not perfect. So, one mask may have a more accurate estimate of mask pressure than another mask. Suspect it has nothing to do with the mask type, but is due to the estimation effect.

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txmnjim +0 points · 3 months ago

thanks Sierra! i'm seeing them today...

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